Southwark's adult social care rated 'Good' by CQC, but faces nursing home shortage
Southwark's adult social care services have been rated 'Good' by the Care Quality Commission (CQC), but the borough faces a significant shortage of nursing home provision, leading to many residents being placed out of area.
The Health, Adult Social Care and Community Safety Scrutiny Commission heard that while the overall rating for adult social care is positive, the CQC report identified several strengths beyond a 'person-centred approach' and 'compassionate staff' that contributed to the 'Good' rating. These included strong multi-agency working, a well-regarded positive behaviour support team, and the council's commitment to becoming an anti-racist organisation. Effective leadership from both officers and members was also noted, with particular praise for Councillor Linford Hall's thorough scrutiny. The inspection found no cases where people were unsafe out of 50 audited cases, highlighting good person-centred care and support, and a clear learning and reflective culture among staff. The All-Age Disability Service was also recognised for providing a good pathway into adulthood.
David Quirke-Thornton, Strategic Director of Children's and Adults' Services, presented the findings of the CQC inspection, highlighting that the service received a 'Good' rating overall. However, he noted that the report identified several areas for improvement. These included longer waiting lists for Occupational Therapy (OT) assessments and a backlog of Deprivation of Liberty Safeguards (DoLS) applications.
At the time of the CQC assessment, there were 321 people waiting for an OT assessment, with a median wait time of 49 days and a maximum of 154 days, exceeding the local authority's internal target of 28 days. The report did note that wait times had reduced in the six months leading up to the assessment, and that the recruitment of more OTs, with only one vacancy, was expected to positively impact waiting times.
Regarding DoLS applications, 146 people were awaiting assessment (excluding community DoLS), with a median wait time of 70 days against a local target of 21 days. The DoLS coordinator had reviewed all individuals on the waiting list, prioritising based on waiting time and other factors. While the authorisation process was noted as slow, the report indicated that the backlog had significantly shrunk and was expected to disappear soon due to legislative changes and sufficient resources.
Councillor Esmé Dobson raised concerns about the CQC's inspection framework, suggesting that some issues, such as damp and mould, were outside the scope of the Care Act. Councillor Pascale Mitchell expressed disappointment at the removal of funding for Saltic Carers and inquired about plans to reinstate similar support.
David Quirke-Thornton responded that the previous providers for carers did not secure the contract for a new carer service. However, another provider did, and a contract is set to be awarded soon for a new, all-age carer service supporting both young and adult carers. This service will be funded from the Better Care Fund and is expected to be fully operational for several years, with its procurement journey complete and ready for decision.
The primary reason for the shortage of nursing home provision in Southwark is the lack of sufficient nursing care homes within the borough, leading to a high number of residents being placed out of area. The CQC report explicitly states, The lack of Nursing home provision was mentioned 4 times in different sections of the report, see below: - Many people are placed out of area in other local authorities - There was a small care market with many people placed out of borough, mostly in neighbouring boroughs some further away - The shortage of care homes in the borough contributes to delayed discharges - There is an undersupply of nursing Care and complex care in the borough.
To address this, the council acknowledges the need for more in-borough nursing care provision. Councillor Dobson highlighted that the Asylum Road care home development is a direct response to this need. Plans are in place to grow and develop additional in-borough care capacity so more residents could stay locally rather than being placed out of borough.
This includes expanding provision for specialist learning disability supported living, culturally specific and need-specialist home care, and services for individuals with behaviours that challenge. Increasing nursing care provision and additional extra care housing is also planned. As an interim measure, some residential care capacity is being converted to nursing care. The expansion of FlexiCare extra care housing is intended to mitigate demand for residential care and create additional capacity. Furthermore, a planning application for a new dementia care nursing home has been approved, and a land transaction for another new nursing care home in Peckham is in progress. The council is also providing targeted support to providers to develop existing properties or new sites for nursing care.
Further details on the CQC inspection can be found in the public reports pack for the Health, Adult Social Care and Community Safety Scrutiny Commission meeting on Wednesday 21 October 2026. Public reports pack